AB1352 IMPACT OF SYSTEMIC THERAPIES ON THE SEROPREVALENCE OF SARS-CoV-2 IN PATIENTS WITH IMMUNE-MEDIATED DISEASES
Authors: M. L. C. Romero Bogado, M. Steiner, T. Cobo-Ibáñez, A. Gómez, B. Paredes Romero, I. Thuissard Vasallo, C. Andreu Vazquez, A. V. Esteban Vazquez, M. A. Matias de la Mano, L. Cebrián Méndez, C. Garcia Yubero, M. D. M. Esteban-Ortega, N. Maceñido Marcos, R. Pajares Villarroya, M. D. R. Arribas Lopez, C. Esteban Alba, A. Martinez Hernandez, R. Guillen Santos, I. Garcia, M. T. Navio Marco, S. Muñoz-Fernández
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The disease modifying antirheumatic drugs (DMARD) impair the immune response of patients with immune-mediated inflammatory diseases (IMID). <h3>Objectives</h3> To analyze the seroprevalence of SARS-CoV-2 in patients with IMID treated with biological disease modifying antirheumatic drugs (bDMARD) or targeted synthetic (tsDMARD). <h3>Methods</h3> An ambispective cross-sectional study was performed in patients with IMID treated with bDMARD or tsDMARD. Seroprevalence was compared by measuring IgG against SARS-CoV-2 between October 2020 and May 2021. <h3>Results</h3> A total of 550 patients with IMID were studied, all of them on bDMARD or tsDMARD therapy, none of them vaccinated at that time against SARS-CoV-2. Patients receiving anti-TNFα therapy had a higher seroprevalence than other biologic and synthetic targeted therapies (OR= 1.792; 95% CI 1.088-2.951; p= 0.021). Patients with bDMARD or tsDMARD treated concomitantly with some type of conventional synthetic DMARD (csDMARD) presented a lower seroprevalence compared to patients treated in monotherapy, 10.7 vs. 19.9% (p= 0.003). When analyzing the treatments with the different csDMARD separately (methotrexate, leflunomide, sulfasalazine, azathioprine, hydroxychloroquine and the others), methotrexate was determined to influence in a lower seroprevalence, compared to those who did not receive any csDMARD, 9.8 vs 19.9% (OR= 0.439, 95% CI 0.232-0.828; p= 0.011). When evaluating the influence of methotrexate on seroprevalence among the different groups of bDMARD or tsDMARD, a lower seroprevalence was demonstrated in the group of patients receiving anti-TNFα and methotrexate in combination, versus patients on this bDMARD in monotherapy, 10.1 vs 24.1% (OR= 0.355, 95% CI 0.165 - 0.764; p=0.006). No significant differences were identified with the other bDMARD. Regarding the patients' IMIDs, no differences in seroprevalence were observed when compared by disease groups with each other. <h3>Conclusion</h3> Seroprevalence in the group of patients with IMID is influenced according to the therapy received, being higher in patients receiving anti-TNFα monotherapy, but significantly lower if concomitant to this drug they receive methotrexate. These differences are not seen with the other b/tsDMARD and csDMARD. <h3>References</h3> [1]Muñoz-Fernández S, Cebrian L, Thuissard IJ, Martina Steiner M, García-Yubero C, Esteban AV et al. Incidence of COVID-19 in 902 Patients With Immunomediated Inflammatory Diseases Treated With Biologics and Targeted Synthetic Disease-Modifying Antirheumatic Drugs-Findings From the BIOCOVID Study. J Clin Reumatol. 2022 Mar 1; 28(2): e348-e352. [2]Favalli EG, Gobbini A, Bombaci M, Maioli G, et al. The Impact of Anti-rheumatic Drugs on the Seroprevalence of Anti-SARS-CoV-2 Antibodies in a Cohort of Patients With Inflammatory Arthritis: The MAINSTREAM Study. Front Med (Lausana), March 2022. [3]Simon D, Tascilar K, Kleyer A, Fagni F, Krönke G, Médeet C et al. Impact of cytokine inhibitor therapy on the prevalence, seroconversion rate and longevity of the humoral immune response against SARSCoV- 2 in an unvaccinated cohort. Arthritis &amp; Rheumatology Vol. 74, No. 5, May 2022, pp 783–790 <h3>Acknowledgements</h3> Olga Reillo from Hospital Universitario Infanta Sofía (Librarian - Documentalist) <h3>Disclosure of Interests</h3> None Declared.